Bloomberg feature on closure of maternity wards, hospitals in rural America

Claire Suddath reports for Bloomberg under the headline, "A Very Dangerous Place to Be Pregnant Is Getting Even Scarier."  The subhead is, "Texas leads the US in maternity ward closures, and nowhere is this more of an issue than in the western part of the state."  Suddath's story features Dr. Adrian Billings of Alpine, home of Big Bend Regional Medical Center. But the physician serves patients who live much farther afield from Alpine, and like those in Alpine, they face tough decisions when pregnant.  

[F]or more than a year, Big Bend’s labor and delivery unit has closed routinely, sometimes with little notice. Some months it’s been open only three days a week.

Big Bend is the only hospital in a 12,000-square-mile area that delivers babies. If Billings’s patient goes into labor when the maternity ward is closed, she’ll have to make a difficult choice. She can drive to the next nearest hospital, in Fort Stockton, yet another hour away. Or, if her labor is too far along and she’s unlikely to make it, she can deliver in Big Bend’s emergency room. But the ER doesn’t have a fetal heart monitor or nurses who know how to use one. It also doesn’t keep patients overnight.

Big Bend doesn’t really have a choice. In the past two years, almost all its labor and delivery nurses quit. The hospital has tried to replace them, but the national nursing shortage caused by the pandemic has made that impossible. When Big Bend is too short-staffed to deliver a baby safely, its labor and delivery unit has to close.

Since 2020, dozens of hospitals have closed or suspended their maternity services.

A 2017 post about the crisis in rural labor and delivery units is here, from when this issue last attracted widespread media coverage.  A Washington Post story by Eli Saslow about the rural physician/hospital shortage in West Texas is here.  A Kaiser Health News story about the maternal health crisis in the catchment area of Big Bend Medical Center is here.  Recent Axios analysis of rural hospital closures is here.  Here's a July Kaiser Health News story about the work of nurse midwives in rural areas.  And this is a story about an innovative health care center serving farmworkers with wraparound services in western North Carolina.